1215388061 NPI number — DR. AARATHI RAVISH RAO MDS DDS

Table of content: DR. AARATHI RAVISH RAO MDS DDS (NPI 1215388061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215388061 NPI number — DR. AARATHI RAVISH RAO MDS DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAO
Provider First Name:
AARATHI
Provider Middle Name:
RAVISH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MDS DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
S
Provider Other First Name:
AARATHI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215388061
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RIB MOUNTAIN ORAL SURGERY
Provider Second Line Business Mailing Address:
4107, BARBICAN AVENUE, SUITE 200
Provider Business Mailing Address City Name:
WESTON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54476
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-757-2905
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RIB MOUNTAIN ORAL SURGERY
Provider Second Line Business Practice Location Address:
4107 BARBICAN AVENUE,STE 200
Provider Business Practice Location Address City Name:
WESTON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54476
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-513-7667
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/23/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 204E00000X , with the licence number:  1002252 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223S0112X , with the licence number: DN123236 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)